Urology, Nephrology and Andrology International

Background: Stricture and fibrosis is the result of wound healing by chronic inflammation resulting in the formation
of scar. Stricture Urethra patients have varied clinical presentations from Irritative to Voiding lower urinary tract
symptoms (LUTS). The present study was undertaken to record the investigations and initial management of urethral
structure disease. Materials and Methods: It is a non - randomized prospective studyconducted in 50 Men with a
diagnosis of Urethral stricture disease, who underwent Urethroplasty (n=25), VIU (n=25). Pre-operative symptom
assessment and investigations were done and treatment outcomes such as Subjective assessment, Objective tests
and complications were studied. Statistical Analysis: Chi square test, Cramer’s V test, Repeated Measures ANOVA
was the tests used for statistical analysis of data using SPSS software. Result & Discussion: The most common
cause of urethral stricture is external trauma (32%) and in Group 2, most common cause is Iatrogenic (48%). This
did not show any statistically significant (p=0.591) difference when Cramer’s V test for symmetric measures was performed (p=0.505 and p=0.591 respectively). VIU as a treatment option for patients with short-segment bulbar strictures has a success rate of ~ 60%, with the emaining requiring a secondary procedure within 6 months. 

Keywords: Urethral stricture disease; Visual Internal urethrotomy; Balanitis Xerotica Obliterans; Membranous Urethral Stricture; Buccal Mucosa Graft Urethroplasty.
 

Vaginal flatulence is considered a pelvic floor disorder in females that is described as passage of odourless gas from the genital tract. It causes significant distress and embarrassment to sufferers. Vaginal flatus mostly starts after vaginal delivery or sometimes spontaneously, however, it is also reported after caesarean section and other pelvic operations. It is less common in virgin young females as compared to parous females. The treatment of this condition are various including kegel exercises, placement of vaginal pessary, anterior and posterior colporrhaphy. We report a case of young virgin female who came with vaginal flatus posed a diagnostic dilemma and improved with conservative treatment. 

Keywords: Garrulitus vulvae; Vaginal flatus; Vaginal wind; Vaginal flatulence. 

The transradial approach is by far the commonest route nowadays for performing percutaneous coronary intervention (PCI), as it is associated with a fewer local complications. Arteriovenous fistula (AVF) is a wellrecognized complication after cardiac catheterization via the femoral or brachial approach. However, an AVF related to the transradial approach is extremely rare. We encountered a rare case of well-developed radio-cephalic AVF at wrist joint after a transradial PCI. 

Keywords: Arteriovenous fistula; Transradial PCI. 

Background: Urethral Stricture Disease is a disease affecting middle-aged men. The causes of urethral stricturecan be categorized as congenital, traumatic, inflammatory, malignant, ischaemicand degenerative. The aim of the study was to compare the short-term treatment outcomes in urethral stricture disease following VIU and Urethroplasty. Materials and Methods: It is a non - randomized prospective study conducted in 50 Men with a diagnosis of Urethral stricture disease, who underwent Urethroplasty (n=25), VIU (n=25). Pre-operative symptom assessment and investigations were done and treatment outcomes such as Subjective assessment, Objective tests and complications were studied. Statistical Analysis: Chi square test, Cramer’s V test, Repeated Measures ANOVA was the tests used for statistical analysis of data using SPSS software. Result & Discussion: In the study groups, Uroflowmetry showed significant improvements in both groups at 1, 3- and 6-months follow-up visits. Secondary procedure was required in 28% of the patients, 16% in Group 1 and 40% in Group 2. Although patients in Group 2 required a secondary procedure more frequently than those in Group 1, this difference was not statistically significant (p=0.059). There was a decline in the Qmax during follow-up at 3 and 6 months. The Mean fall in Qmax at 3 months and 6 months was 3.6 ml/sec and 1.56 ml/sec respectively in Group 1, and 5.52 ml/sec and 0 ml/sec respectively in Group 2. Although short-term results with the present study reflect a very high success rate favouring BMG substitution urethroplasty, a larger cohort and a longer follow-up may be required for a better assessment of this modality for management of USD. 

Keywords: Urethral Stricture disease; Visual Internal urethrotomy; Urethroplasty; Buccal Mucosa Graft Urethroplasty.

Background: Crescentic glomerulonephritis (CSGN) requires early intervention which can make a significant impact on minimizing irreversible kidney damage and improving patient outcomes Data regarding the clinical and histopathologic spectrum of CSGN among the Indian adult population is sparse. Objective: To study the etiology, clinicopathological features, prognostic factors and outcome of CSGN in Indian population. Method: This prospective, descriptive study was carried out in the Department of Nephrology, St John’s Medical College Hospital, Bengaluru which is a large territory care hospital in South India from July 2015 to October 2017. 37 patients diagnosed as CSGN on renal biopsy were studied. Results: The mean age of presentation in our study was 38.8 ± 13.7 years. The most common clinical presentation was in the form of rapidly progressive renal failure (54.1%). The most common etiological diagnosis was immune complex mediated glomerulonephritis (64.8%), followed second by pauci-immune GN (27%). Among immune complex group, IgA nephropathy was the leading cause (32.4%) and had the worst prognosis. The serum creatinine at presentation was an important prognostic marker with value of more than 5 mg/dl having poor outcome with 75% reaching end stage renal disease. Almost half of patients (50%) requiring renal replacement therapy at presentation reached end stage renal disease (ESRD). Conclusion: Crescentic GNs most commonly seen between third to fifth decades of life. Immune-complex glomerulonephritis (IgA nephropathy being the predominant disease) is the most common etiology of CSGN followed by anti-neutrophil cytoplasmic antibody positive pauci-immune GN. The predominant factors influencing renal outcomes were the extent of renal failure at presentation, need for renal replacement therapy at presentation and renal histology. Early diagnosis and therapy may facilitate favourable renal and patient outcomes. 

Keywords: RPGN; Crescentic glomerulonephritis; South India.